Chronic kidney disease and clear renal cell carcinoma metastasis following radical or partial nephrectomy

  • Pehuén Fernández Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Javier De Arteaga Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Carlos Chiurchiu Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Walter Douthat Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Sofía Naser Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Facundo Schwarz Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Pamela Borgogno Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
  • Raúl Colla Servicio de Urología, Hospital Privado Centro médico de Córdoba, Córdoba, Argentina
  • Alejandro Sosa Servicio de Urología, Hospital Privado Centro médico de Córdoba, Córdoba, Argentina
  • Jorge De La Fuente Servicio de Nefrología, Hospital Privado Centro Médico de Córdoba, Carrera de Postgrado de Nefrología, Universidad Católica de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Fundación Nefrológica de Córdoba, Córdoba, Argentina
Keywords: renal insufficiency, chronic; nephrectomy; carcinoma, renal cell; kidney neoplasms

Abstract

Introduction: Partial nephrectomy to treat early-stage renal cell carcinoma has become one of the surgeries of choice for patients in Argentina. However, long-term results in the country are unknown. In this study, we analyzed the progression to chronic kidney disease and the appearance of metastasis after partial or radical nephrectomy in renal cell carcinoma patients. Methods: A retrospective, cohort study was conducted. We included all patients suffering from T1 stage clear cell renal carcinoma who, between 2006 and 2012, underwent nephrectomy in our hospital. Follow-up continued until January 2018. Results: Thirty-two patients were included (19 had undergone radical nephrectomy and 13, partial nephrectomy). Subjects who had radical nephrectomy showed a more rapid progression to chronic kidney disease as compared to the subjects in the partial nephrectomy group (radical nephrectomy 63.2% vs. partial nephrectomy 15.4%; p=0.007). There were no differences in the follow-up period in both groups (radical nephrectomy 69.3% ± 23.8 months vs. partial nephrectomy 72.5 ± 26.9 months; p=0.73). Risk of progression to end-stage chronic kidney disease was 11 times higher for subjects who had undergone radical nephrectomy as compared to subjects who had had partial nephrectomy (adjusted HR 11.12; 95% CI: 1.24-99.9; p=0.031), adjusted by the rest of traditional risk factors. None of the T1a patients had metastasis during follow-up, regardless of the type of surgery. Conclusion: According to the findings of our study, partial nephrectomy preserves long-term renal function better than radical nephrectomy and has an excellent oncologic safety profile in T1a stage renal cell carcinoma patients. Radical nephrectomy was an independent risk factor of progression to chronic kidney disease.

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Published
2021-06-22
How to Cite
1.
Fernández P, De Arteaga J, Chiurchiu C, Douthat W, Naser S, Schwarz F, Borgogno P, Colla R, Sosa A, De La Fuente J. Chronic kidney disease and clear renal cell carcinoma metastasis following radical or partial nephrectomy. Rev Nefrol Dial Traspl. [Internet]. 2021Jun.22 [cited 2024Dec.27];41(2):82-8. Available from: http://vps-1689312-x.dattaweb.com/index.php/rndt/article/view/644
Issue
Vol. 41 No. 2 (2021): Abr.-Jun.
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Original Article

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